Customer Service Representative I

Job Summary

Providing exceptional support to Medicaid members, the full-time Customer Service Representative I will resolve enrollment issues, educate new members, and ensure compliance with eligibility guidelines while working remotely from the Eastern Standard Time Zone.

Key responsibilities

• Resolve and reconcile enrollment reports and eligibility issues according to policies and state guidelines
• Initiate communication with newly enrolled members and provide necessary literature and instructions
• Research and address claims issues, offering support to member and provider services staff

Required qualifications

• High School Diploma or Equivalent (GED) required
• Minimum of 1 year of customer service experience required
• Familiarity with Medicaid policies and procedures preferred
• Ability to interpret rules and regulations related to health plan enrollment
• Experience with data management and reporting tools is a plus